Drs. Oz and Roizen: Taking an antibiotic? Don’t forget the good bugs

Here’s a gut check. Up to 39 percent of people who take an infection-fighting antibiotic wind up with diarrhea, a side effect that can be annoying or even downright life-threatening.

Why? Because along with killing off infection-producing culprits, antibiotics slay good gut-dwelling bacteria that protect you from gastrointestinal distress. And those good guys do many other beneficial things for you, too, including building and maintaining your immune strength.

Side effects like diarrhea are probably why 20 percent of folks stop taking their antibiotics before they should – and that can be even more dangerous than the initial infection. If some of the disease-causing bacteria have not yet been slain – chances are they were the strongest of the lot – you can get doubly ill as they rebound and begin to multiply again.

A new report shows that pairing antibiotics with “good” bacteria (probiotics) slashes the risk of antibiotic side-effects.

Raising your intake of probiotics – the beneficial bacteria found in your guts and available in supplements and foods like yogurt, tempeh and kefir – can lower your odds of getting diarrhea by a whopping 64 percent. It also can slash your risk by 66 percent for illness associated with a dangerous type of tough-to-kill bacteria, clostridium difficile (or C. diff) that shows up in hospitals and afflicts the young and elderly.

Trillions (no exaggeration, really) of bacteria hang out in your digestive system, where they help process the food you eat and play important roles in keeping your immune system strong, your body weight in check and your mood rosy. Helpful gut bacteria aid digestion by breaking down sugars called polysaccharides, as well as the amino acids in proteins. Some even make vitamins and act as anti-inflammatory agents, reducing the risk of everything from arthritis to clogged arteries.

There’s also evidence that a healthy and well-balanced colony of good and bad bacteria can help protect against stomach ulcers, lower odds for urinary-tract infections and ease the symptoms of irritable bowel syndrome. All good stuff. But when you take an antibiotic to clear up or prevent an infection, without a counterbalance of probiotics, you end up with fewer good bugs on board and nasty types can get the upper hand.

So let your doctor know that you plan to take probiotics with the antibiotic and for five days longer than your prescription. If he gives you the go-ahead – generally, taking probiotics isn’t recommended for people with a compromised immune system – here’s how to make the most of this opportunity to keep things balanced:

• Taking a supplement? Look for “spore form” probiotics. They are tough guys that can withstand a bath in your stomach’s super-strong digestive acids. We prefer the spore probiotics that contain bacillus coagulans GBI-30, 6086 and lactobacillus GG, a strain activated by stomach acid.

• Choose food with the right good bacteria. More and more probiotic products crowd the dairy aisle in the supermarket, each teeming with a different group of beneficial bacteria. What’s best? For preventing or helping to calm antibiotic-associated diarrhea, try Saccharomyces boulardii and a combination of Lactobacillus acidophilus and Lactobacillus casei. Other types proven to run “the runs” out of town include Lactobacillus rhamnosus GG, Lactobacillus reuteri and Lactobacillus acidophilus.

• Don’t overlook yogurt. You don’t have to take a probiotic supplement to get benefits. There’s evidence that a daily serving of yogurt can cut risk for diarrhea by two-thirds. Just make sure your carton says “live active cultures.” Choose plain, nonfat yogurt to avoid loading up on saturated fat and sugar. Mix in chopped fruit and a couple of walnuts for flavor.